The Future of Psychotherapy

Peter Bowes introduced the UKCP Conference theme ‘The future of Psychotherapy’. He is to give a one hour workshop from the perspective of a trauma psychotherapist. He asked the group to watch and consider two TED talks on UTube and consider two questions;
1. What is it that each of us believes we are dong as a therapist when in touch with presentations of our clients that point to attachment issues?
2. And when we do what we do, how do we think change takes place?

The first TED talk featured Fin Williams who referred to her personal story that she had absorbed, which was probably an outcome of her parents’ self-perceptions and self-narratives and that those stories had shaped her development. She related how being aware of her own story eventually enabled her to think of herself differently and positively. She also told how she was then able to recall the positive memories of her parenting which had previously remained ‘out of sight’. Fin’s talk ended with her imploring the audience, to write their own narratives of their stories and share them with another trusted friend.

The second TED talk was one of many on UTube by Dan Siegel. He reviewed an aspect of disorganised attachment in five minutes by means of an anecdote of a father telling his son to brush his teeth. This father experienced an eruption of rage when challenged by an attempt at autonomy by his son to not be so instructed. In this presentation, Dan noted how a triggered rage shut down the father’s pre-frontal cortex and how that response might escalate and then lead to an attack on the child. He noted how mirrors neurons would have communicated in both directions the unconscious perceptions and read by both father and son with the concomitant emotions arising for both from the activated neural paths laid down by earlier attachment processes. The father is re-traumatised and the son traumatised (not for the first time one may assume!).

Each of the group courageously then wondered about how they thought as therapists about their client presentations. We challenged ourselves to wonder how we thought that change like that narrated by Fin Williams takes place. It was not easy for us to more beyond change of thinking for the client at first before moving into the awareness that change of feeling was essential. We probably agreed together that therapy required as a sine qua non an authentic unconditional positive regard in which the experience of the client is validated. Dan Siegel’s framework of neuro-biologically informed construal of what happens between human beings requires acknowledgement and awareness of the reality of mirror neurons however and thus the demand upon us as therapists to engage fully and genuinely in a relationship of love of the other. This brings also the demand on us to continuously develop acute sensitive empathic awareness of the other and the capacity and ability to sense whether that awareness is of the therapists feelings or those of the client. Any unacknowledged inauthenticity will be communicated through the activity of ‘mirror neurons’.

The discussion concluded with us thinking about the future of psychotherapy. It is possible that neuro-biological research may lead us to become more aware of the conditions that allow the brain to change and for the ability to reflect on one’s own inner world to develop. Thus self – regulation and personal resilience, deficient due to inadequate attachment processes, might be re-discovered and reformed at a fundamental neurological level. If we do get to understand the conditions that enable that brain change would we not ‘have to’ do what we can to bring about those conditions?

Authors and books mentioned were:
Ecker, Ticic and Hulley, Unlocking the Emotional Brain
Panksepp and Biven, The Archeology of the Mind
Lanious, Paulsen and Corrigan, Neurobiology and the Treatment of Traumatic Dissociation. Towards and Embodied Self.

The Future of Psychotherapy